INTRODUCTION: Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years. METHOD: A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). RESULTS: Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence. CONCLUSION This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.
Adolescent ; Adult ; Humans ; Male ; Young Adult ; Anti-HIV Agents/administration & dosage* ; Feasibility Studies ; Health Risk Behaviors ; HIV Infections/psychology* ; Incidence ; Medication Adherence ; Mental Health/statistics & numerical data* ; Pilot Projects ; Pre-Exposure Prophylaxis/statistics & numerical data* ; Sexual and Gender Minorities/statistics & numerical data* ; Sexually Transmitted Diseases/prevention & control* ; Singapore/epidemiology* ; Telemedicine/statistics & numerical data* ; Homosexuality, Male/statistics & numerical data*

BACKGROUND: This study aimed to examine (1) the patterns of online health information search with respect to seeking and scanning, and (2) how online search, along with eHealth literacy, predicts perceived information usefulness in the context of diet and weight control. METHODS: Online survey was conducted with 299 adults from the consumer panel recruited for the purpose of quality assessment of the Korean National Health Information Portal in 2016. We conducted paired sample t-test and multiple logistic regression to address the research questions. Data analysis was performed using IBM SPSS Statistics ver. 24.0 (IBM Corp., Armonk, NY, USA) and SAS ver. 9.3 (SAS Institute Inc., Cary, NC, USA). RESULTS: Of the respondents, 38.8% were ‘high seek-high scanners,’ 35.8% were ‘low seek-low scanners,’ 13.0% were ‘high seek-low scanners,’ and 12.4% were ‘low seek-high scanners.’ eHealth literacy was a significant, positive predictor of online information scanning (odds ratio [OR], 2.46; 95% confidence interval [CI], 1.41–4.29), but not for online information seeking (OR, 1.75; 95% CI, 1.00–3.05). With respect to perceived usefulness of online information seeking, online seeking (OR, 4.90; 95% CI, 2.19–11.00) and eHealth literacy (OR, 2.30; 95% CI, 1.11–4.75) were significant predictors. Perceived usefulness of online scanning had a significant association with online scanning (OR, 2.38; 95% CI, 1.08–5.22), but not with eHealth literacy. CONCLUSION: To increase the effectiveness of the health policy for online information search and related outcomes in the context of diet and weight control, it is important to develop education programs promoting eHealth literacy.
Adult ; Diet ; Education ; Health Policy ; Humans ; Information Seeking Behavior ; Literacy ; Logistic Models ; Statistics as Topic ; Surveys and Questionnaires ; Telemedicine ; Weight Loss

OBJECTIVES: Smartphones represent a promising technology for patient-centered healthcare. It is claimed that data mining techniques have improved mobile apps to address patients’ needs at subgroup and individual levels. This study reviewed the current literature regarding data mining applications in patient-centered mobile-based information systems. METHODS: We systematically searched PubMed, Scopus, and Web of Science for original studies reported from 2014 to 2016. After screening 226 records at the title/abstract level, the full texts of 92 relevant papers were retrieved and checked against inclusion criteria. Finally, 30 papers were included in this study and reviewed. RESULTS: Data mining techniques have been reported in development of mobile health apps for three main purposes: data analysis for follow-up and monitoring, early diagnosis and detection for screening purpose, classification/prediction of outcomes, and risk calculation (n = 27); data collection (n = 3); and provision of recommendations (n = 2). The most accurate and frequently applied data mining method was support vector machine; however, decision tree has shown superior performance to enhance mobile apps applied for patients’ self-management. CONCLUSIONS: Embedded data-mining-based feature in mobile apps, such as case detection, prediction/classification, risk estimation, or collection of patient data, particularly during self-management, would save, apply, and analyze patient data during and after care. More intelligent methods, such as artificial neural networks, fuzzy logic, and genetic algorithms, and even the hybrid methods may result in more patients-centered recommendations, providing education, guidance, alerts, and awareness of personalized output.
Artificial Intelligence ; Data Collection ; Data Mining* ; Decision Trees ; Delivery of Health Care ; Early Diagnosis ; Education ; Follow-Up Studies ; Fuzzy Logic ; Humans ; Information Systems* ; Mass Screening ; Methods ; Mobile Applications ; Patient Care ; Self Care ; Smartphone ; Statistics as Topic ; Support Vector Machine ; Telemedicine

OBJECTIVES: A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT). This paper reviews mIoT and big data in healthcare fields. METHODS: mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences. RESULTS: Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination. All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs. Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making. CONCLUSIONS: A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge. These workers will possess the skills and the ability to interpret and understand health and well-being data. They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall. As the global population ages, such roles will become increasingly important.
Chronic Disease ; Cognition ; Commerce ; Cost Control ; Delivery of Health Care* ; Disease Management ; Efficiency ; Health Education ; Humans ; Internet* ; Life Style ; Mental Health ; Mobile Applications ; Smartphone ; Statistics as Topic ; Telemedicine ; Wireless Technology

OBJECTIVES: Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. METHODS: This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. RESULTS: Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. CONCLUSIONS: The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making.
Artificial Intelligence ; Follow-Up Studies* ; Health Information Systems ; Health Services ; Heart Failure* ; Heart* ; Home Care Services ; Humans ; Learning ; Negotiating ; Statistics as Topic ; Telemedicine

OBJECTIVES: Recent advances in mobile technology have opened up possibilities to provide strongly integrated mobile-based services in healthcare and telemedicine. Although the number of mobile Electronic Health Record (EHR) applications is large and growing, there is a paucity of evidence demonstrating the usage patterns of these mobile applications by healthcare providers. This study aimed to illustrate the deployment process for an integrated mobile EHR application and to analyze usage patterns after provision of the mobile EHR service. METHODS: We developed an integrated mobile application that aimed to enhance the mobility of healthcare providers by improving access to patient- and hospital-related information during their daily medical activities. The study included mobile EHR users who accessed patient healthcare records between May 2013 and May 2014. We performed a data analysis using a web server log file analyzer from the integrated EHR system. Cluster analysis was applied to longitudinal user data based on their application usage pattern. RESULTS: The mobile EHR service named M-UMIS has been in service since May 2013. Every healthcare provider in the hospital could access the mobile EHR service and view the medical charts of their patients. The frequency of using services and network packet transmission on the M-UMIS increased gradually during the study period. The most frequently accessed service in the menu was the patient list. CONCLUSIONS: A better understanding regarding the adoption of mobile EHR applications by healthcare providers in patient-centered care provides useful information to guide the design and implementation of future applications.
Delivery of Health Care ; Electronic Health Records* ; Health Personnel ; Humans ; Korea* ; Medical Informatics Applications ; Mobile Applications ; Patient-Centered Care ; Statistics as Topic ; Telemedicine ; Tertiary Care Centers* ; Wireless Technology

BACKGROUND: Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. METHODS: After close analysis of the Italian and European reference regulatory framework and work-related stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. RESULTS: We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. CONCLUSION: This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons.
Efficiency ; Health Policy ; Italy* ; Jurisprudence ; Methods ; Occupational Health ; Risk Assessment* ; Statistics as Topic ; Telemedicine

Based on Model-JC Focused Ultrasound Tumor Therapeutic System developed by Chongqing HAIFU (HIFU) Technology Co., Ltd., this paper presents a equip-data discrete management and multi-process equip-data input system along with its design profile and experimental data. And a time-efficiency model is finally set up for multi-process processing.
Management Information Systems ; Models, Theoretical ; Neoplasms ; diagnosis ; Telemedicine ; instrumentation ; statistics & numerical data ; Ultrasonic Therapy ; instrumentation ; statistics & numerical data

BACKGROUND: Telemedicine(tele+medicine=medicine at a distance) is a health care delivery system to deliver health care to patients at distant sites. In Korea, medical counseling by PC communication is nearly the only available field in the telemedicine at present. However, the concerns of telemedicine is growing as an issue, and dermatologists in Korea should be prepared for "the era of teledermatology". OBJECTIVE: We analyzed the queries of PC communication and the internet. Based on the results of the analysis, we tried to establish a more effective medical counseling system by PC communication and make them basic data to prepare the utilization of telemedicine system. METHODS: We analyzed questions and answers in ten sites in a computer mediated communication system from Jan 1 to Dec 31, 1997. RESULTS: The proportion of questions in dermatologic area among all medical fields was relatively high(8.7-13.4%). The frequency was acne, urticaria, alopecia, and so on, in an order of high frequency, which was different from previous results in a statistical study of outpatients in dermatology. Reasons for questions were to know the treatment method(42.2%), to get the diagnosis (23.7%), and so on. Contents of answers were explanation(46.5%), advice to visit doctors(40.4%), and so on. CONCLUSION: The proportion of dermatologic questions in telemedicine was high, and there are possibilities of dermatology's being important in the future of telemedicine. Therefore, dermatologists should be prepared for the future telemedicine era. However, teledermatology should be evaluated thoroughly and improved because we could see some problems in that.
Acne Vulgaris ; Alopecia ; Counseling* ; Delivery of Health Care ; Dermatology ; Diagnosis ; Humans ; Internet ; Korea ; Outpatients ; Statistics as Topic ; Telemedicine ; Urticaria